Waist circumference partially mediates the non-linear association between TyHGB and MASLD in non-diabetic Japanese adults

Figures

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  FIGURE 1. Flowchart of the study participants.the NAGALA, Non-Alcoholic Fatty Liver Disease in the Gifu Area Longitudinal Analysis; T2DM, Type 2 diabetes.

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  FIGURE 2. Associations between TyHGB and prevalence of MASLD. (A,B) Associations between TYHGB and prevalence of MASLD. The solid red line represents the smooth curve fit between variables. Blue bands represent the 95% confidence interval from the fit. They were adjusted for age, sex, hypertension, smoking status, drinking status, exercise status, HbA1c, WC, ALT, AST, GGT, and LDL-C. MASLD, Metabolic dysfunction-associated steatotic liver disease; TyHGB, Triglyceride high-density cholesterol-glucose body index; WC, Waist circumference; HbA1c, Glycosylated hemoglobin; ALT, Alanine aminotransferase; AST, Aspartate aminotransferase; GGT, Gamma-glutamyl transpeptidase; LDL-C, Low-density lipoprotein cholesterol.

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  FIGURE 3. Associations between TyHGB and the prevalence of MASLD by sex (A), age (B), BMI (C), TG (D), hypertension (E), and WC (F). They were adjusted for age, sex, hypertension, smoking status, drinking status, exercise status, HbA1c, WC, ALT, AST, GGT, and LDL-C. In subgroup analyses, the model was not adjusted for the classified variables. MASLD, Metabolic dysfunction-associated steatotic liver disease; TyHGB, Triglyceride high-density cholesterol-glucose body index; BMI, Body mass index; WC, Waist circumference; HbA1c, Glycosylated hemoglobin; ALT, Alanine aminotransferase; AST, Aspartate aminotransferase; GGT, Gamma-glutamyl transpeptidase; TG, Triglycerides; LDL-C, Low-density lipoprotein cholesterol.

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  FIGURE 4. ROC curves comparing the predictive value of TyHGB with TyG, and AIP for MASLD onset, with predictive efficacy assessed by AUC in the general population. MASLD, Metabolic dysfunction-associated steatotic liver disease; TyHGB, Triglyceride High-Density Cholesterol-Glucose Body Index; AIP, Atherogenic index of plasma; TyG, Triglyceride-glucose; ROC, Receiver operating characteristic; AUC, Area under the curve.

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  FIGURE 5. ROC curves comparing the predictive value of TyHGB with TyG, and AIP for MASLD onset, with predictive efficacy assessed by AUC. (A,B) Sex stratification: TyHGB outperformed TyG and AIP in males (A) and females (B). (C,D) Age stratification: TyHGB showed better predictive performance in subjects < 40 years (C) and ≥ 40 years (D). (E,F) BMI stratification: TyHGB showed higher predictive efficacy in BMI < 25 kg/m2 (E) and ≥ 25 kg/m2 (F). (G,H) TG stratification: TyHGB outperformed TyG, and AIP in TG < 1.7 mmol/L (G) and ≥ 1.7 mmol/L (H). (I,J) Hypertension stratification: TyHGB outperformed TyG and AIP in non-hypertension (I) and hypertension (J). (K,L) WC stratification: TyHGB outperformed TyG and AIP in Normal WC (K) and Elevated WC (L). MASLD, Metabolic dysfunction-associated steatotic liver disease; Triglyceride high-density cholesterol-glucose body index; BMI, Body mass index; WC, Waist circumference; TG, Triglycerides; AIP, Atherogenic index of plasma; TyG, Triglyceride-glucose; ROC, Receiver operating characteristic; AUC, Area under the curve. Elevated WC was defined as ≥ 90 cm in men and ≥ 80 cm in women; normal WC was defined as < 90 cm in men and < 80 cm in women.

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  FIGURE 6. The mediation effect of WC between TyHGB and MASLD in the general population. Adjusted for age, sex, hypertension, smoking status, drinking status, exercise status, HbA1c, ALT, AST, GGT, and LDL-C. MASLD, Metabolic dysfunction-associated steatotic liver disease; TyHGB, Triglyceride high-density cholesterol-glucose body index; WC, Waist circumference; HbA1c, Glycosylated hemoglobin; ALT, Alanine aminotransferase; AST, Aspartate aminotransferase; GGT, Gamma-glutamyl transpeptidase; TG, Triglycerides; LDL-C, Low-density lipoprotein cholesterol.

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  FIGURE 7. The mediation effect of WC between TyHGB and MASLD by sex (A,B), age (C,D), BMI (E,F), TG (G,H), hypertension (I,J), and WC (K,L). Adjusted for age, sex, hypertension, smoking status, drinking status, exercise status, HbA1c, ALT, AST, GGT, and LDL-C. In subgroup analyses, the model was not adjusted for the classified variables. MASLD, Metabolic dysfunction-associated steatotic liver disease; TyHGB, Triglyceride high-density cholesterol-glucose body index; BMI, Body mass index; WC, Waist circumference; HbA1c, Glycosylated hemoglobin; ALT, Alanine aminotransferase; AST, Aspartate aminotransferase; GGT, Gamma-glutamyl transpeptidase; TG, Triglycerides; LDL-C, Low-density lipoprotein cholesterol. Elevated WC was defined as ≥ 90 cm in men and ≥ 80 cm in women; normal WC was defined as < 90 cm in men and < 80 cm in women.